Care Home: Princes Road, 46

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What the care home does well People are happy living at the home. They feel well cared for and supported by staff. The staff are happy working there and feel that they have the information and support they need to do their jobs. There is a happy and relaxed atmosphere. Families are able to stay in touch and be involved with people`s care if they want. The home is well maintained, clean and fresh. Records are well organised, up to date and clear. What has improved since the last inspection? Individual people who live at the home have had their own personal achievements. There have been improvements to the information given to people and they have been given the opportunity to be involved in new aspects of running the home, such as staff recruitment. Records are kept up to date and are well organised. Some new records and ways to monitor quality have been introduced. There have been some improvements to the environment. What the care home could do better: The acting manager has a plan for continuous monitoring and improving of the service. She speaks to the people who live at the home and staff and asks for their opinions and ideas. We made some suggestions for change and she has listened to these and acted upon them. The acting manager and staff need to continue to monitor how people experience the service and look at ways to make sure they get even better support in the future. Key inspection report Care homes for adults (18-65 years) Name: Address: Princes Road, 46 Princes Road, 46 Teddington Middlesex TW11 0RU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sandy Patrick     Date: 1 8 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Princes Road, 46 Princes Road, 46 Teddington Middlesex TW11 0RU 02086148090 02086148090 l.atherton@richmond.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): London Borough of Richmond upon Thames Name of registered manager (if applicable) Miss Lesley Margaret Atherton Catherine Louise Gregg Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 46 Princes Road is a care home providing residential care and accommodation for six service users with a learning disability. The home has been operating since 1994. The building is owned by London Quadrant Housing Association. The service is managed by the London Borough of Richmond. The building has three storeys and is divided into two flats. There is an internal door Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 6 Brief description of the care home between the two flats, which can be accessed by service users. The ground floor flat has level access in order to meet the needs of service users who have wheelchairs. All bedrooms are for single occupancy and two have en suite facilities. The home is located close to shops, pubs and other local amenities. Information about the service is available in the Statement of Purpose and Service User Guide. Fees are not applicable to this home as it is an in-house service funded by the London Borough of Richmond. However, residents are expected to pay towards holidays. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The inspection included an unannounced visit to the home on the 18th June 2009. We met with 3 of the people who live there and staff on duty. We looked at the environment, records and how people were being supported. We wrote to the acting manager and asked her to complete a quality self assessment. We wrote to people who live at the home, their representatives and staff and asked them to complete surveys about their experiences. We looked at all the information we had received since the last inspection, this included an annual service review which we carried out on the home in 2008. Care Homes for Adults (18-65 years) Page 6 of 26 Some of the things people told us about the home were They always put people who live there first. We respect each persons individuality. The staff are always polite and caring. Princes Road feels like a family home. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is enough information to help people make a decision about moving to the home, including opportunities to spend time there. People have their needs assessed to make sure the home is the right place for them. Evidence: There is a guide to the home for people who are interested in moving there. The staff are creating a new DVD guide. People who live at the home have done so for a long time. They told us that they had enough information to help them make the decision to move there and that they had opportunities to visit and stay before they moved in. The London Borough of Richmond has procedures to make sure people who are interested in moving to the home are assessed to make sure the home is suitable for them. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported by staff who know their needs, wishes and interests. Clear and accurate records help people to understand about the support they are getting. Different methods of communication are used to help make sure everyone has as much choice and control over their lives as possible. Evidence: Everyone at the home has their needs recorded in a plan which the staff can use and refer to. Copies of peoples key needs are in their bedrooms so that any staff member supporting someone can see what they need to do. More detailed support plans are available and these tell the staff about peoples likes, dislikes, needs and wishes. People have been involved in creating their plans. The staff have used pictures and photographs to explain about individual peoples needs. The information about people is very good. It is clear, easy to understand and kept up to date. Each month the staff review the care and support everyone has received and write a report about this. We saw that changes were made to someones care if needed. People told us that they were given the help and support they needed. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: The staff have assessed the risks people face so that they can do things to help keep them safe. We saw that people were supported to take risks and to make informed choices. Everyone has a member of staff assigned to them, a keyworker. This person helps make sure their needs are met, they are listened to and changes they need take place. Some people who live at the home attend a local forum, where they meet with other people in the borough to discuss things which are important to them. The acting manager recently involved the people living at Princes Road in recruiting staff. She asked them all to tell her what they thought was important in a staff member. She used this information and knowledge of the individual interests and likes of everyone to create a job description. This is really good as it helps people to get the staff they need and want. There are monthly meetings for people who live at the home to discuss changes, forthcoming events and things that are important to them. We saw records of these. There is a notice board of information which lets everyone know what they are going to do each week. The board uses photographs and pictures to help people understand. Photographs and pictures are also used to help people chose what they want to shop for and eat. This is good and helps the staff communicate more clearly with the people they are supporting. We felt the staff could use even more pictures and photographs to help label other things, for example where different things go in the kitchen. This may help people feel more in control of their own home and could help people to be more independent. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported to try new things, develop skills, be part of the local community and maintain friendships and relationships. They are valued by staff and others who support them. Evidence: People who live at the home are supported to choose, shop for and plan their menus and the things that they do. Everyone does different things according to their individual needs and wishes. Some people have jobs and some people go to college. The staff at the home support everyone to learn skills and to do things that they enjoy and think are fun. People told us that they were supported to do the things they wanted to. One staff member told us, we are always looking for ways to improve peoples lives for example new college course, days out or activities. One person told us that they Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: were looking at different college courses that they might want to do next year. The contributions people make to the house are valued. For example, their art work is displayed. People use the local community, leisure facilities and public transport. Everyone is supported to go on holiday if this is what they want. People are supported to maintain friendships and family links. Some people see their families regularly and the staff support them with travelling or arranging visits. We saw that families and other important people were consulted when the staff create care plans and that their opinions are valued. One staff member told us, we actively encourage contact with families. Throughout our visit we saw the staff showed respect to people, asking their opinions and giving them clear information. People told us that they felt the staff respected them and that they liked the staff and found them friendly. One professional who works with people living at the home said, the staff are always very respectful of their clients and willing to support them. Another professional told us, the staff are always polite and caring. Everyone is involved in planning, shopping and preparing the food they eat. The acting manager told us that the staff supported people to eat healthily and be aware of this. We saw that pictorial menus were on display to help people remember what the planned meal was. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to stay healthy and have their personal care and medication needs met by well trained, sensitive and caring staff. Evidence: The staff have created a health action plan for everyone. This helps them to know each persons health needs and how to monitor these and care for them. We saw that these records were good. Everyone is registered with a local GP and other health care professionals as needed. We saw records that showed people had regular consultations. Professionals told us that the staff were good at communicating with them and acted on their advice. People are supported to keep clean and have their personal needs met. Individual needs are recorded and monitored and we saw that staff treated people with respect. There is an appropriate medication procedure. All the staff have had training in Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: administering medication. We found that medication was suitably stored. Medication supplies are checked regularly. Records of administration were accurate. The staff we spoke to had a good knowledge of peoples medication and health needs. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are kept safe by staff following procedures. People know that they are able to raise concerns and feel confident that these will be acted upon. Evidence: There is an appropriate complaints procedure and everyone has had a copy of this. People told us that they knew what to do if they were unhappy about anything. There have been no formal complaints since the last inspection. There is a record of concerns which shows what action has been taken to resolve these. The London Borough of Richmond has procedures in safeguarding adults and whistle blowing. The staff have all had training in these areas. The staff we spoke to had a good understanding of what to do if they were concerns about someones safety. The staff help people to manage their finances. They keep small amounts of cash for people to use when they need. There are accurate records of this and it is checked daily. There are records of all expenditure and this is regularly audited. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained, pleasant and attractive home. They have been supported to personalise this. Evidence: The home is located in Teddington close to shops and public transport. There is a pleasant well kept garden. Everyone has their own room and some of these have en suite facilities. They have personalised their rooms. There are two lounges and other shared communal facilities. The environment is well maintained. At the time of the inspection one WC was being refurbished and two people had chosen new flooring for their bedrooms. The outside of the house and some communal areas were due to be redecorated. Some areas of the building showed wear and tear. For example a banister on the stairwell was loose and a carpet in one lounge was worn. The acting manager told us that these were being attended to. There are plans to refurbish the kitchen. The acting manager told us that they were looking at accessibility of cupboards and work surfaces in the new kitchen so that people who live at the home could find it easier to use. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: The home was fresh throughout. We found that there were no paper towels in the bathrooms. The acting manager has since arranged for paper towels in all WCs and bathrooms as this will help reduce the risk of cross infection. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are cared for by well trained, appropriately recruited and supported staff. Evidence: Many of the staff have worked at the home for a long time. They know the people who live there well. There is good information for staff on their roles and responsibilities. There is a plan for each day which the staff help to create, this makes sure that all the things that need doing each day are allocated to specific staff. There are guidelines and publications available for staff to refer to. One person who lives at the home told us, the staff are all fantastic. There is a daily handover of information between each shift change and regular team meetings. We saw records of these. The staff are all able to contribute their ideas and they told us that they feel valued and listened to. The London Borough of Richmond provides a range of different training opportunities. We saw that the staff working at Princes Road have undertaken lots of training. The acting manager makes sure everyones training is up to date and relevant. The staff have undertaken NVQ qualifications. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The acting manager and deputy manager hold regular individual supervision meetings with all staff. These are recorded. The staff told us that they felt supported and had opportunities to discuss their work. The staff members we met showed a good knowledge about each of the people who live at the home. They told us that they used their different skills to support people in different ways. For example one member of staff helps people to try different arts and crafts and another member of staff is using their computer to create a DVD guide to the home. The London Borough of Richmond has appropriate procedures for recruiting staff, including reference and criminal record checks. People living at the home have recently been involved in recruiting staff and this is really good. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home, where the quality of the service is monitored and there are plans for continuous improvement. Evidence: The acting manager has worked at the home for many years. She was promoted to acting manager when the Registered Manager left in 2008. She has applied to be registered with CQC. She is appropriately experienced and qualified. She has an excellent knowledge of people who live at the home and the needs of the service. The local authority employ people independent of the home to monitor the quality of the service. They visit each month and meet with people who live and work there and look at specific quality issues. Recent visits looked at accessibility issues and friendships. They write a report of their findings and make recommendations if they feel things could be improved. Quality is also monitored through regular checks on the environment, meetings with people who live at the home and staff, individual support and meetings for everyone Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: and regular reviews of each persons care and appraisals of each staff members work. There are well organised and accessible records at the home. These are regularly reviewed and kept up to date. We saw evidence of regular checks on health and safety, including fire safety, electrical equipment and water temperatures. There are regular checks on fire safety equipment and we saw evidence of these. There are emergency evacuation plans for everyone who lives at the home and risk assessments to help the staff to understand how to keep people safe in an emergency. These are regularly updated. The staff have fire drills to practice what they would need to do to support people in event of a fire and these are recorded. The staff have fire safety training. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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